Magister Administrasi Rumah Sakit (MARS)

Program Pasca Sarjana

Universitas Muhammadiyah Yogyakarta

SMART
HOSPITAL
Winny Setyonugroho, S.Ked., M.T., Ph.D.
How Smart are Hospitals now?
⮚ Smart hospitals make extensive use of innovative technologies to
improve care quality and patient experience while reducing costs.

⮚ Technology is a tool, quality of care is the goal

⮚ Take the first step : interconnected information systems, next step

will be easier and impactful

⮚ Prioritization, Change and Project Management – get some win

every time
 Setting the Context
✔ Cost of healthcare delivery and need to improve access to care :

Global costs of healthcare delivery continue to rise, with the healthcare industry accounting for almost 10% of the global. GDP. In
the context of such high expenditures and an aging population (driven by a decline in population growth rate but increased life
expectancy), there is a fast-growing economic imperative for rethinking how care is delivered. 

✔ Complexity of care :

With rapid advancements in treatment options, diagnostic capabilities and biotechnology, the model of care itself is changing
rapidly. The industry is experiencing a radical shift in care pathways, utilizing multidisciplinary care approaches and fostering a
model towards a continuum of care for the patient.

✔ Increased patient involvement :

Growth of chronic diseases continues to push much higher involvement of the patient in the treatment cycle, thereby improving
the quality of care through better knowledge sharing, personalizing care and improving accessibility of treatment.
What is E-Health?

⮚ it is a relatively new direction at the

intersection of medicine, information,
health, and business, which is related to
the usage of information technology
support for healthcare.
 The Technology

⮚ The computer is getting smaller

Computer technology is an expanding branch of engineering, with roots in both electrical engineering

and computer science. It includes the related areas of computer hardware and software; computer

interfacing, programming, and networking; analog and digital electronics; and robotics.

⮚ Software

Software is a set of instructions, data or programs used to operate computers and execute specific tasks.

It is the opposite of hardware, which describes the physical aspects of a computer. Software is a generic

term used to refer to applications, scripts and programs that run on a device. It can be thought of as the

variable part of a computer, while hardware is the invariable part.

 Current Technology Drive Digital Health
⮚ Wearable Biosensing

Wearable devices (WDs) have evolved from purely

mechanical devices to intelligent mechatronic systems
thanks to the continuous advance of technology
integrating sensors, actuators, novel materials,
computation, and above all sensory feedback.

⮚ Telemedicine
Telemedicine allows health care professionals to
evaluate, diagnose and treat patients at a distance
using telecommunications technology. The
approach has been through a striking evolution in
the last decade and it is becoming an increasingly
important part of the healthcare infrastructure.
⮚ EHR & clinical workflow
EHR or electronic health record are digital records of health information. They contain all the
information you’d find in a paper chart — and a lot more. EHRs include past medical history,
vital signs, progress notes, diagnoses, medications, immunization dates, allergies, lab data and
imaging reports. They can also contain other relevant information, such as insurance information,
demographic data, and even data imported from personal wellness devices.

An EHR:
Goes wherever the patient goes and gets shared by healthcare providers. As an all-inclusive
patient record, it can powerfully help improve patient care and health outcomes.
Gives clinicians access to a wider range of patient data compared to an EMR. Such access
facilitates better-informed decision making and care planning.
Meets meaningful use standards for incentive programs administered by the Centers for
Medicare & Medicaid Services (CMS). This compliance is an important reason why the healthcare
industry is increasingly using EHR systems.
⮚ Remote medicine

Remote Medical Care is a telemedicine service, which allows constant monitoring of the patient’s
condition and performance of preventive and control check-ups outside medical facilities. This form of
care is made possible by the use of mobile devices which measure vital signs. Results are transmitted to
the Remote Medical Care Center, where they are automatically analyzed. If any abnormalities are
detected, medical staff contact the patient and calls an ambulance in the event of an emergency.
⮚ Analytic & Big Data
Big data analytics examines large amounts of
data to uncover hidden patterns, correlations
and other insights. With today’s technology, it’s
possible to analyse your data and get answers
from it almost immediately
Big data analytics helps organizations harness
their data and use it to identify new
opportunities. That, in turn, leads to smarter
business moves, more efficient operations,
higher profits and happier customers.
The Benefits of Analytic & Big Data
⮚ Cost reduction. Big data technologies such as Hadoop and cloud-based analytics bring
significant cost advantages when it comes to storing large amounts of data – plus they can
identify more efficient ways of doing business.
⮚ Faster, better decision making. With the speed of Hadoop and in-memory analytics,
combined with the ability to analyze new sources of data, businesses are able to analyze
information immediately – and make decisions based on what they’ve learned.
⮚ New products and services. With the ability to gauge customer needs and satisfaction
through analytics comes the power to give customers what they want. Davenport points out
that with big data analytics, more companies are creating new products to meet customers’
needs.
⮚ Patient engagement

 is defined as patients actively engaged in gathering information and making decisions about their
symptoms, illnesses, and treatment options. A more expansive definition includes a vibrant
partnership between patients, their families, their representatives, and their healthcare team.
Benefit:
For patients who received enhanced support instead of usual support:
• Total medical costs were 5.3 percent lower
• Inpatient admissions were 12.5 percent lower
• ER visits were 2.6 percent lower
• Surgeries were 9.9 percent lower
• Heart surgeries were 10.9 percent lower
• From this and other studies, it’s clear that patients and providers can positively impact
healthcare costs and patient outcomes through patient engagement.
 Information System Concept
All in all, we can conclude that all those factors above can be 
simplified into 3 things

⮚ Digitalization

⮚ Connectivity

⮚ Automation
⮚ The Internet of Things (IoT) describes the network of physical objects—“things”—
that are embedded with sensors, software, and other technologies for the purpose of
connecting and exchanging data with other devices and systems over the internet.
These devices range from ordinary household objects to sophisticated industrial
tools.

⮚ The Internet of Things (IoT) is a network of connected… well, ‘things’. These ‘things’
(devices) communicate with each other using machine to machine communication
(M2M).

⮚ Information is traversed between devices so that processes can be automated,

without the need for human intervention.
⮚ IoT and Accuracy

For many businesses minimising errors is a main priority, and whether we like it or not people make mistakes.
Human error is something that is often overlooked or discounted when refining processes. By connecting
machines and allowing them to control themselves automatically, fewer members of staff are needed to complete
certain tasks.

⮚ Increase up-time with the IoT

Another advantage of automating your business processes using IoT is an increase in up-time. Machines aren’t
restricted by time. Automating your business processes via the Internet of Things will allow them to run 24/7.

⮚ IoT Analysis and Monitoring

The beauty of the Internet of Things (IoT) isn’t necessarily the improved performance of business processes. In a
modern-day business, analytics and logistics are becoming more and more important as technology develops.
Understanding why a problem has occurred or identifying areas of improvement is getting much easier because of
this.
Digital Transformation in Healthcare
 Key Factors for going digital to Smarter
Hospital

✔ Create a culture for digital transformation.

✔ Consider technology that communicates.
✔ Make needed investments manageable.
✔ Organizations should create a strong, system-wide data infrastructure.
✔ Prepare for Talent
✔ Maintain cyber security
 What drives success in designing the
smart-hospital strategy?
⮚ Organizational commitment to the smart-hospital agenda:

Creating a role that leads the “SMART” agenda for the hospital – a role that goes beyond just managing
technology, but rather drives how technology enables the functioning, outcome and patient experience. This
role is not just a virtual function within the organization delivered by a committee, but a necessary a role
anchored in the organizational structure, with the mandate of achieving the smart-hospital vision.

⮚ Rethinking the enterprise-architecture approach:

Conventional technology strategies focused on automation, and the mechanics of building such strategies,
need to be rethought. With a fast-developing portfolio of innovative technologies that will have a fundamental
impact on the hospital’s services and operations, a smart hospital’s technology blueprint and the conventional
approaches to building these need to adapt rapidly.
⮚ Partnering, not just procuring :

This includes a shift in the processes, mindset and capabilities of the procurement organization. This does not
mean doing away with the existing efficiency of the procurement function, but rather adding capabilities that
allow it to create risk-shared, innovative approaches for adapting to and adopting a new breed of service
providers that are rapidly adding new and innovative capabilities to the portfolio of health technologies.

⮚ Creating a learning organization:

Creating the management systems, performance systems and more importantly, the culture that motivates the
staff within the hospital to constantly upskill their capabilities, is critical, particularly in areas around
deployment of new-technology-enabled ways of working. This is not new to healthcare systems, in which
continuing professional development has been a

clear requirement of the clinical staff – smart hospitals need to expand the system to go beyond and apply the
same up-skilling mandate and systems to the non-clinical part of the organization as well.
What are the E-Health

Benefits?
 What are the E-Health Benefits?
⮚ Patient Engagement

Using smart hospital room features (for example, via touch-screen monitors or tablets) patients and their
families can enhance their experience and improve patient-doctor relationships. They can be involved in the
care process and know more about treatment progress and health condition. While staying in the hospital
room they can view their health records and test results, get to know daily treatment schedules. The smart
hospital also provides opportunities for disease management education.

⮚ Streamlining communication

Patients are often dissatised with the doctor-patient communication as in some cases doctors are more focused
on a computer screen than on talking to the patient and monitoring his or her emotions and body language,
which often give additional information about the patient’s condition. And patient satisfaction is an important
index in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, the
scores of which directly affect reimbursement. Leveraging mobile and IoT technologies allows effective and
timely
⮚ Workflow optimization

IoT and mobile technology can also give healthcare organizations effective tools to improve performance while
tracking and identifying bottlenecks and service slowdowns. Hospital navigation for patients and staff. Smart
hospital applications can help patients and visiting or temporary physicians and staff to find a way in the
hospital. Messaging and routing features can provide turn-by-turn directions and arrival time instructions to
make navigation in large hospitals simpler and less stressful for visitors.

⮚ Patient notification

This smart hospital software feature can significantly reduce the no-show rates, which cost the US healthcare
system $150b each year. Push notifications generated by such software can be sent to patients, in their
preferred language, informing them about the time of their appointment and the exact office number. Such
smart hospital systems can also push updates telling the patients if the appointment location or time has
changed.
⮚ Hospital assets tracking

IoT is extensively used in many other industries for effective inventory tracking. Hospitals and
care centers can use IoT healthcare applications to find out which items need to be reordered and
where the assets are located

⮚ Leveraging data analytics

Smart devices like wearables and smartphones track huge volumes of biometric data. This data
can be used by caregivers to find out more about both individual patients and populations.
Insights from the data can improve the quality of patient care and accelerate lifesaving research.
The world over, a number of factors are rapidly driving a new paradigm in healthcare delivery. Smart
hospital is not a set standard that defines a facility as intelligent or not. Rather it is an approach that
encourages managers to look at each division of their operation through the lens of smart technology
and find real solutions to real challenges to achieve improved patient outcomes and operational
productivity.
⮚ What to start?
○ Start with the Basics, Then Move Forward
When selecting a smart hospital solution, consider how the integration will be achieved and how it
will be supplied. It is important to highlight that the more systems that need to be integrated, the more
expensive and complex the project becomes and the longer it will take to implement.
A lot of smart hospital implementations become stalled because businesses try to take on too much
at once. They attempt to pull everything together under one platform in a short time but find the
difficulties of such an endeavor overwhelming. This can lead to frustration and a lack of clear wins
along the way, causing the deployment to stall or stop entirely.
As the solution is evaluated, consider the most important dashboards that are a priority for the
different stakeholders that were involved in the selection process. Taking a more simplified, realistic and
pragmatic approach will help to avoid overwhelming an organization—both in terms of costs and
workforce hours—as well as prevent information overkill and project fatigue
 Why the first step in Information System Development is so
important?
The first step in the information system development process is system analysis. While every step of
the development process is important, the first step sets the tone and ensures that your organization is
moving forward in the right direction. The first step of the process can be broken down into three sub-
steps. These system analysis sub-steps are:
● Identification
● Selection
● Planning
Let’s take a closer look at these sub-steps and explain their importance in the information system
development process.
❖ Identification
This is the very beginning of the development process. Here, your team will be looking at the
problems and challenges facing your organization. They will also be examining your current
information system and how adept it is at handling your needs.
For example, if you rely on IoT devices, you need an information system that can process, store, and
analyze large amounts of data. In this part of the development process, your teams need to be
looking for opportunities to address the challenges facing your organization.
Failure to properly identify the challenges your organization faces will make it nearly impossible
for you to find the right information system solutions.
❖ Selection
After you clearly define your needs, challenges, and potential system solutions, you need to make a
final decision. You should not rush the selection process because once you have a new system, you
will hopefully be using it for years to come.

Evaluate how each potential solution handles the needs of your business and the challenges you
face. Take the time to think about how this information system solution will aid you in reaching
your targets.

Do you need a whole or a partial information system solution? Does your solution require a
custom app? You should have a clear idea about exactly how your business will benefit from a
specific system design and how it will integrate with your current system.

Your team should have a list of features most important to your organization so that you can
evaluate and compare options so that your organization is choosing the best solution for your
needs.
❖ Planning
Once your needs have been identified and a solution selected, you need to create an
implementation plan for your information system. Arguably, this planning phase is simpler if
you’re completely replacing your current system.

If you’re updating parts of your information system, you will need a more detailed integration plan.
You should know which aspects of your system will be implemented first, who will be trained on
the updates, etc.

The most successful projects are well planned. Take the time to put together a comprehensive
implementation plan so that the process is as frictionless as possible.
❖ Final Thoughts
Developing a new information system can be a challenging task. The first step in this development
process is system analysis. The more thorough and detailed you are in this initial step, the more
likely it is that your project will be successful.

We understand that developing information systems can be a challenge. If you need a helping
hand, reach out to an app development partner. They can give you an abundance of technical
expertise and industry experience. A partner is a valuable resource during any development
project.
Winny Setyonugroho Phd
wsetyonugroho@umy.university

wsetyonugroho@umy.ac.id

pakwinny.staff.umy.ac.id
Sekian &

Terima Kasih
Program Pasca Sarjana
Universitas Muhammadiyah Yogyakarta
2020
 Note
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